London: The world's best stand-up comedians - household names including Kevin Hart, Amy Schumer, Jimmy Fallon, Chris Rock, Jerry Seinfield, Ricky Gervais, Eddie Murphy and many more - are likely to die than comedic and dramatic screen and stage actors, according to a lstudy published in the International Journal of Cardiology.

The study - Is the last 'man' standing in comedy the least funny? A retrospective cohort study of elite stand-up comedians versus other entertainers - revealed "a pattern of premature mortality in elite stand-up comedians" indicating that higher comedic standing is linked to younger age at death compared to screen comedians and so-called serious dramatic actors.

This retrospective cohort study of 498 people included 200 Stand-up Comedians (13% women), 114 Comedy Actors (17.5% women), and 184 Dramatic Actors (29.3% women) listed in the top 200 in each category on popular online crowd-ranking website http://www.ranker.com. These individuals appeared in the 2015 lists 'Funniest Stand-Up Comedians of All Time', 'Funniest People of All Time' and 'Greatest Actors and Actresses in Entertainment History'.

Lead researcher Professor Simon Stewart, a world-leading cardiac researcher from the Mary MacKillop Institute of Health Research at Australian Catholic University, said there was a "significant gradient in the age of death, with stand-up comedians dying at a younger age (67.1 years) than their comedy actor (68.9) and dramatic actor (70.7) counterparts".

"Indeed, the data confirmed an adverse relationship between comedic ability and longevity, with elite standup comedians more highly rated by the public more likely to die prematurely," Professor Stewart said. "Overall, the results point to a need for awareness of health and wellbeing concerns in the entertainment industry, and in elite comedians in particular."

"It appears that for stand-up comedians, being at the very top may be no laughing matter."

The MacKillop Institute research confirmed "significantly more deaths among stand-up comedians (14 of 36 deaths - 38.9%) categorised as 'premature' relative to population-based, life expectancy when compared to dramatic actors (11 of 56 -19.6%), with no difference when compared to comedy actors (9 of 33 deaths - 27.3%)". And stand-up comedians experienced proportionately more non-natural deaths (7 of 36 - 19.4%) than their comedy actor (3 of 33 - 9.1%) and dramatic actor (6 of 56 - 10.7%) counterparts. Of note, stand-up comedians contributed to both reported suicides and 4 of 9 drug-related deaths.

"Within an international cohort of stand-up comedians spanning the last century and voted by the public as the funniest of their profession, we discovered that greater comedic ability was associated with a shorter lifespan, even after adjusting for life expectancy differences based on year of birth," he said. "Conversely, in parallel cohorts of the world's funniest comedy actors and the greatest dramatic actors, there was no evidence of premature mortality related to public-rated professional success or ability."

Professor Stewart noted how his previous study - 'Does comedy kill? A retrospective, longitudinal cohort, nested case-control study of humour and longevity in 53 British comedians' - had found that the funniest comedians are most at risk of premature death and reduced longevity, compared to their less funny counterparts. That finding encouraged MacKillop researchers to undertake a "more extensive and objective study of this intriguing phenomenon".

"We suspected that if our original conclusions were correct, we would find that the purer and funnier the comedy art form, i.e. stand-up, the more strongly this premature death phenomenon would manifest itself," Professor Stewart said. "Specifically, we hypothesised that among stand-up comedians the inverse association between comedic ability and longevity would be both present and demonstrably stronger than observed in an equivalent cohort of comedy."

Professor Stewart's latest research confirmed the hypothesis.

Professor Stewart noted the widespread association between high social status and low mortality - as evidenced in a study finding that Academy Award winners live longer - does not extend to every occupation. "Indeed stand-up comedians don't share the 3.9-year life expectancy advantage enjoyed by Oscar-winning actors, which highlights an intriguing and as-yet-unexamined discrepancy," he said.

By way of further discussion, Professor Stewart referenced an important 1993 study, which demonstrated that higher parent and teacher ratings of a child's sense of humour and cheerfulness-optimism predicted a greater likelihood of dying over seven decades. Also noted was how comedians appear to exhibit higher levels of psychotic traits (including manic-depression and schizotypal features) than non-comedians - and at higher levels than actors.

Professor Stewart's research also discusses the "demands inherent to stand-up comedy" - a "highly competitive profession with low pay and low job security; years of working under this pressure may exert a cumulative stress effect even once success has been achieved". "In contrast, elite dramatic actors (a category that applies to the current http://www.ranker.com cohort, as well as to the Academy Award winners described earlier) are more likely to have attained some degree of financial security, with the attendant benefits to health and wellbeing," he said.

Stand-ups expected to behave 'erratically' compared to more 'serious' actors

Further still, "stand-up comedians and dramatic actors may also face distinct social and professional expectations". "Successful dramatic actors are often regarded as 'role models' and expected to maintain a positive public image, with managers and 'minders' invested in enforcing certain standards of behaviour that might exert a protective effect on health and longevity. This does not appear to apply to stand-up comedians, who are often expected to behave eccentrically," Professor Stewart said. "In fact, in contrast to the highly supervised environment of a film set, the nature of the comedy 'workplace' (i.e., night venues such as clubs and bars) increases exposure to and engagement in violence and risky sexual behaviour, as well as consumption of alcohol, tobacco and drugs."

In concluding remarks, Professor Stewart said: "The current results reveal a pattern of premature mortality in elite stand-up comedians, and taken together with our previous findings, indicate that higher comedic standing is linked to younger age at death. Intrapersonal factors such as personality and other psychological features that help to develop and enhance the creative talent and success of these comedians may simultaneously contribute to their reduced longevity. External or social pressures specific to stand-up comedy may also play a role."